Exam #10

Which of the following would be an inaccurate clinical manifestation of a retinal detachment? A) Pain B) Sudden onset of a greater number of floaters C) Cobwebs D) Bright flashing lights

A) Pain

Which instructions regarding swimming should the nurse give to a client who is recovering from otitis externa? Select all that apply. A) Wear soft plastic earplugs. B) Wear a scarf. C) Avoid cold water. D) Insert a loose cotton earplug in the external ear.

A) Wear soft plastic earplugs. The nurse should advise the client to wear soft plastic earplugs to prevent trapping water in the ear while swimming. Wear soft plastic earplugs to prevent trapping water in the ear while swimming.

Which statement is consistent with acute otitis media? A) The infection usually lasts more than 6 weeks. B) It is a relatively uncommon childhood infection. C) It is usually caused by a fungal infection. D) Conductive hearing loss may occur.

D) Conductive hearing loss may occur

During a routine physical examination, the nurse practitioner notes that a 72-year-old patient has a significant loss of ability to discriminate words. The patient also states that he has noticed that he has trouble hearing high-frequency sounds. The nurse suspects that the patient has an age-related change in his ears known as: A) Cerumen hardening. B) Alterations in the vestibulospinal reflex. C) Thickening of the eardrum. D) Degeneration of the organ of Corti.

D) Degeneration of the organ of Corti Degeneration of the organ of Corti causes a decreased ability to discriminate high frequencies or to interpret consonant sounds. Refer to Table 48-2 in the text. Alterations in the vestibulospinal reflex affect balance and gait.

A nurse practitioner in an emergency room receives a telephone call from a mother whose 4-year-old child has a mosquito stuck in his external ear canal. Which of the following is the best information the nurse could give the mother? A) Irrigate the ear canal with warm water to flush out the insect. B) Use an aural suction cup to pull out the insect. C) Insert a cotton-tipped applicator (e.g., Q-tip) to trap the insect and slowly pull the applicator backward. D) Instill a few drops of warmed mineral oil to cover the insect.

D) Instill a few drops of warmed mineral oil to cover the insect. Removing a foreign body from the external auditory canal can be quite challenging. The three standard methods for removing foreign bodies are the same as those for removing cerumen: irrigation, suction, and instrumentation. Foreign vegetable bodies and insects tend to swell; thus, irrigation is contraindicated. Usually, an insect can be dislodged by instilling mineral oil, which will kill the insect and allow it to be removed.

The nurse is caring for a client diagnosed with Guillain-Barre syndrome. His spouse asks about recovery rates. The nurse can correctly relate which of the following? A) Approximately 60% to 75% of clients recover completely. B) Only a very small percentage (5% to 8%) of clients recover completely. C) Usually 100% of clients recover completely. D) No one with Guillain-Barre syndrome recovers completely.

A) Approximately 60%-75% of clients recover completely.

A nurse is caring for a client who requires intracranial pressure (ICP) monitoring. The nurse should be alert for what complication of ICP monitoring? A) Coma B) Infection C) High blood pressure D) Apnea

B) Infection The catheter for measuring ICP is inserted through a burr hole into a lateral ventricle of the cerebrum, thereby creating a risk of infection. Coma, high blood pressure, and apnea are late signs of increased ICP, not complications.

The most common site of metastasis in clients diagnosed with rhabdomyosarcoma is the A) brain. B) lungs. C) bone. D) lymph nodes.

B) Lungs.

What inner ear structure is affected when a patient is diagnosed with otosclerosis? A) Malleus B) Stapes C) Incus D) Tympanic membrane

B) Stapes

The nurse caring for a client with Ménière's disease makes which primary assessments? A) Ability to function B) Social support C) Gross hearing D) Level of disability

C) Gross hearing The nurse assesses gross hearing and performs the Weber and Rinne tests. It also is important to determine the extent and effect of the client's disability.

Which is the priority nursing diagnosis when caring for a client with increased ICP who has an intraventricular catheter? A) Fluid volume deficit B) Risk for infection C) Ineffective cerebral tissue perfusion D) Risk for injury

C) Ineffective cerebral tissue perfusion The brain must be adequately perfused to maintain function and prevent long-term disability due to lack of oxygenation. The client is at risk for injury, fluid volume deficit due to a possible fluid restriction to maintain normovolemia, and infection due to the placement of the intraventricular catheter, but these are not the priority.

The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of: A) 0 to 5 mm Hg. B) 6 to 10 mm Hg. C) 11 to 20 mm Hg. D) >21 mm Hg.

D) >21 mm Hg.

Which of the following is the main refracting surface of the eye? A) Cornea B) Iris C) Pupil D) Conjunctiva

A) Cornea The cornea is a transparent, avascular, domelike structure that covers the iris, pupil, and anterior chamber. It is the most anterior portion of the eyeball and is the main refracting surface of the eye. The iris is the colored part of the eye. The pupil is a space that dilates and constricts in response to light. Normal pupils are round and constrict symmetrically when a bright light shines on them. The conjunctiva provides a barrier to the external environment and nourishes the eye.

During assessment for cranial nerve functions, the client closes the eyes and begins to fall to one side. Which cranial nerve alteration causes this response? A) cranial nerve VIII B) optic nerve C) cranial nerve VII D) facial nerve

A) Cranial nerve VIII Nerve receptors for balance are found both in the vestibule and semicircular canals. They transmit information about motion through the vestibular nerve, which joins with the cochlear nerve to form the eighth cranial nerve (formally called the auditory or acoustic nerve).

A client with a traumatic brain injury has developed increased intracranial pressure resulting in dibetes insipidus. While assessing the client, the nurse expects which of the following findings? A) Excessive urine output and decreased urine osmolality B) Oliguria and decreased urine osmolality C) Oliguria and serum hyperosmolarity D) Excessive urine output and serum hypo-osmolarity

A) Excessive urine output and decreased urine osmolality Diabetes insipidus is the result of decreased secretion of antidiuretic hormone (ADH). The client has excessive urine output, decreased urine osmolatity, and serum hyperosmolarity.

A young man has presented for care because he claims that he has experienced hearing loss that he attributes to a summer job at a gravel crusher. On questioning, the clinician learns that the man was provided with hearing protection but was "hit and miss" with using it. What should the clinician teach this patient about sensorineural hearing loss? A) "Hearing loss like you've experienced is permanent because of the destruction of important cells in your ears." B) "You'll likely find that your hearing will improve over the next several years." C) "As long as you're very careful to avoid loud noises, your hearing will probably recover in the following few months." D) "Unfortunately, your hearing loss is likely to get progressively worse because of the process that this damage started.

A) Hearing loss like you've experienced is permanent because of the destruction of important cells in your ears.

The nurse is obtaining a visual history from a client who has noted an increase in glare and changes in color perception. Which assessment would the nurse anticipate to confirm a definitive diagnosis? A) Identification of opacities on the lens B) Identification of white circle around the cornea C) Identification of yellowish aging spot on the retina D) Identification of redness of the sclera

A) Identification of opactities on the lens. The client states an increased glare and changes in color perception, which indicates a cataract. Identification of opacities on the lens confirms that diagnosis. A white circle around the cornea and a yellowish aging spot are also symptoms of aging but with different symptoms. Redness of the sclera indicates irritation.

A female patient's severe ear infection has resulted in tympanic membrane perforation. The patient's care provider has concluded that surgical repair is unnecessary because the membrane is healing spontaneously. What health education should the nurse emphasize to this patient? A) It is important to keep the ear canal dry until the membrane has healed. B) Half-strength hydrogen peroxide should be instilled into the ear once a day. C) The ear should be gently cleaned with a cotton swab once a day. D) Purulent drainage should be expected for the first week after the injury.

A) It is important to keep the ear canal dry until the membrane is healed. While healing, the ear must be protected from water. Purulent discharge indicates infection and would warrant immediate follow-up. Cleaning with a cotton swab could cause injury, and hydrogen peroxide is not indicated.

A nurse is preparing to administer an antiseizure medication to a client. Which of the following is an appropriate antiseizure medication? A) Lamictal B) Lamisil C) Labetalol D) Lomotil

A) Lamictal Lamictal is an antiseizure medication. Its packaging was recently changed in an attempt to reduce medication errors, because this medication has been confused with Lamisil (an antifungal), labetalol (an antihypertensive), and Lomotil (an antidiarrheal).

The nurse is caring for a patient with Ménière's disease who is hospitalized with severe vertigo. What medication does the nurse anticipate administering to shorten the attack? A) Meclizine (Antivert) B) Furosemide (Lasix) C) Cortisporin otic solution D) Gentamicin (Garamycin) intravenously

A) Meclizine (Antivert) Pharmacologic therapy for Ménière's disease consists of antihistamines, such as meclizine, which shortens the attack (NIDCD, 2010).

A nurse is continually monitoring a client with a traumatic brain injury for signs of increasing intracranial pressure. The cranial vault contains brain tissue, blood, and cerebrospinal fluid; an increase in any of the components causes a change in the volume of the others. This hypothesis is called which of the following? A) Monro-Kellie B) Cushing's C) Dawn phenomenon D) Hashimoto's disease

A) Monro- Kellie The Monro-Kellie hypothesis states that, because of the limited space for expansion in the skull, an increase in any one of its components causes a change in the volume of the others. Cushing's response is seen when cerbral blood flow decreases significantly. Systolic blood pressure increases, pulse pressure widens, and heart rate slows. The Dawn phenomenon is related to high blood glucose levels in the morning in clients with diabetes. Hasimoto's disease is related to the thyroid gland.

A client seeks care for lower back pain of 2 weeks' duration. Which assessment finding suggests a herniated intervertebral disk? A) Pain radiating down the posterior thigh B) Back pain when the knees are flexed C) Atrophy of the lower leg muscles D) Homans' sign

A) Pain radiating down the posterior thigh A herniated intervertebral disk may compress the spinal nerve roots, causing sciatic nerve inflammation that results in pain radiating down the leg. Slight knee flexion should relieve, not precipitate, lower back pain. If nerve root compression remains untreated, weakness or paralysis of the innervated muscle group may result; lower leg atrophy may occur if muscles aren't used. Homans' sign is more typical of phlebothrombosis.

Which of the following tests confirms the diagnosis of myasthenia gravis (MG)? A) Tensilon test B) Computed tomography (CT) scan C) Electromyogram (EMG) D) Serum studies

A) Tensilon test

Prior to a clinical placement in an ambulatory ophthalmology clinic where cataract repairs and corneal transplants are performed, a nursing student is conducting a review of the anatomy and physiology of the eye. Which of the following descriptions is most accurate? A) The muscles controlling the eye are innervated by several different cranial nerves. B) The primary function of the conjunctiva is to focus incoming light. C) The anterior chamber of the eye is filled with air that is matched to atmospheric pressure. D) The pupil is a highly vascularized, pigmented collection of fibers.

A) The muscles controlling the eye are innervated by several different cranial nerves. The four rectus muscles and two oblique muscles that control the eye are innervated by cranial nerves (CN) III, IV, and VI. The conjunctiva is protective, and the eye chambers are filled with aqueous humor. The iris is a pigmented collection of fibers, while the pupil is the central opening in the eye

The Monro-Kellie hypothesis explains A) The dynamic equilibrium of cranial contents. B) nonresponse of the brain to the environment. C) the brain's attempt to restore blood flow by increasing arterial pressure to overcome the increased intracranial pressure. D) why the client is awake but lacks consciousness, without cognitive or affective mental function.

A) They dynamic equilibrium of cranial contents The hypothesis states that because of the limited space for expansion within the skull, an increase in any one of the cranial contents (brain tissue, blood, or cerebrospinal fluid) causes a change in the volume of the others. Akinetic mutism is the phrase used to refer to unresponsiveness to the environment. The Cushing response is the phrase used to refer to the brain's attempt to restore blood flow by increasing arterial pressure to overcome the increased intracranial pressure. Persistent vegetative state is the phrase used to describe a condition in which the client is wakeful but devoid of conscious content, without cognitive or affective mental function.

Which method is used to help reduce intracranial pressure? A) Using a cervical collar B) Keeping the head of bed flat C) Rotating the neck to the far right with neck support D) Extreme hip flexion, with the hip supported by pillows

A) Using a cervical collar Use of a cervical collar promotes venous drainage and prevents jugular vein distortion, which can increase ICP. Slight elevation of the head is maintained to aid in venous drainage unless otherwise prescribed. Extreme rotation of the neck is avoided because compression or distortion of the jugular veins increases ICP. Extreme hip flexion is avoided because this position causes an increase in intra-abdominal pressure and intrathoracic pressure, which can produce a rise in ICP.

Which disease includes loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem? A) Parkinson disease B) Amyotrophic lateral sclerosis C) Alzheimer disease D) Huntington disease

B) Amyotrophic lateral sclerosis Amyotrophic lateral sclerosis (ALS) is a disease of unknown cause in which there is a loss of motor neurons in the anterior horns of the spinal cord and the motor nuclei of the lower brain stem. Parkinson disease is a slowly progressing neurologic movement disorder that eventually leads to disability. Alzheimer disease is a chronic, progressive, and degenerative brain disorder that is accompanied by profound effects on memory, cognition and ability for self-care. Huntington disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary choreiform movement and dementia.

Which phase of a migraine headache usually lasts less than an hour?A) Premonitory B) Aura C) Headache D) Postdrome

B) Aura The aura phase occurs in about 20% of clients who have migraines and may be characterized by focal neurological symptoms. The premonitory phase occurs hours to days before a migraine headache. The headache phase lasts from 4 to 72 hours. During the postdrome phase, clients may sleep for extended periods.

The nurse on the medical-surgical floor is reviewing discharge instructions with a patient who has a history of glaucoma. Which classification of drugs on the patient's discharge instructions is used to treat the patient's glaucoma? A) Antiemetics B) Cholinergics C) Antibiotics D) Angiotensin-converting enzyme (ACE) inhibitors

B) Cholinergics Cholinergics are used in the treatment of glaucoma. The action of this medication is to increase aqueous fluid outflow by contracting the ciliary muscle, thus causing miosis and opening the trabecular meshwork.

The clinic nurse caring for a patient with Parkinson's disease notes that the patient has been taking levodopa and carbidopa (Sinemet) for 7 years. What common side effects of Sinemet would the nurse assess this patient for? A) Pruritus B) Dyskinesia C) Lactose intolerance D) Diarrhea

B) Dyskinesia Within 5 to 10 years of taking levodopa, most patients develop a response to the medication characterized by dyskinesia (abnormal involuntary movements). Another potential complication of long-term dopaminergic medication use is neuroleptic malignant syndrome, characterized by severe rigidity, stupor, and hyperthermia. Side effects of long-term Sinemet therapy are not pruritus, lactose intolerance, or diarrhea.

The staff educator is orientating a nurse new to the neurological ICU when a patient with a T2 spinal cord injury is admitted. The patient is soon exhibiting manifestations of neurogenic shock. What sign or symptom is consistent with this diagnosis? A) Increased cardiac biomarkers B) Hypotension C) Tachycardia D) Excessive sweating

B) Hypotension Manifestations of neurogenic shock include decreased blood pressure and heart rate. Cardiac markers would be expected to rise in cardiogenic shock. Patients do not perspire on the paralyzed portions of their body due to blockage of sympathetic activity.

The nurse is caring for a client with recurrent ear infections. The nurse assesses the client for further infectious processes traveling deeper into the tissue and becoming more lethal. Which infection, originated in the ear, is of most concern? A) Mastoiditis B) Meningitis C) Sinusitis D) Labyrinthitis

B) Meningitis The infection stemming for the ear may extend to the meninges, causing meningitis, or a brain abscess could occur. This could be life threatening. The other options are also potential complications of an ear infection.

A patient is brought to the trauma center by ambulance after sustaining a high cervical spinal cord injury 1½ hours ago. What medication does the nurse know will be given to prevent further spinal cord damage? A) Furosemide (Lasix) B) Methylprednisolone (Solu-Medrol) C) Cyclobenzaprine (Flexeril) D) Hydralazine hydrochloride (Apresoline)

B) Methylprednisone (Solu-Medrol) The administration of high-dose corticosteroids, specifically methylprednisolone, has been found to improve motor and sensory outcomes at 6 weeks, 6 months, and 1 year if given within 8 hours of injury. Lasix, Flexeril, and Apresoline are used in the management of spinal cord injury, but do not have an effect on preventing further spinal cord damage, specifically.

The nurse on a cruise ship is assessing clients for motion sickness. Which of the following is a common misconception? A) Repeated motion is the cause. B) Once symptoms occur, they will always be present. C) Medications help the symptoms. D) Pallor and diaphoresis is a first symptom.

B) Once symptoms occur, they will always be present. When the client experiences motion sickness, the client will use that data to avoid further symptoms in the future. The client can use medication, change location or position, and recognize symptoms earlier for symptom management. The other options are correct and teachable statements.

A client with otosclerosis comes to the clinic for a follow-up. When assessing this client's hearing, which type of hearing loss would the nurse expect to find? A) sensorineural B) conductive C) no hearing loss D) loss of high frequency sounds

B) conductive Otosclerosis may involve one or both ears and manifests as a progressive conductive or mixed hearing loss.

Loud, persistent noise has what effect on the body? A) Dilation of peripheral blood vessels B) Increased blood pressure C) Decreased heart rate D) Decreased gastrointestinal activity

B) increased blood pressure Loud, persistent noise has been found to cause constriction of peripheral blood vessels, increased blood pressure, increased heart rate, and increased gastrointestinal motility.

The nurse is caring for a client following a spinal cord injury who has a halo device in place. The client is preparing for discharge. Which statement by the client indicates the need for further instruction? A) "I will change the vest liner periodically." B) "If a pin becomes detached, I'll notify the surgeon." C) "I can apply powder under the liner to help with sweating." D) "I'll check under the liner for blisters and redness."

C) I can apply powder under the liner to help with sweating. Powder is not used inside the vest because it may contribute to the development of pressure ulcers. The areas around the four pin sites of a halo device are cleaned daily and observed for redness, drainage, and pain. The pins are observed for loosening, which may contribute to infection. If one of the pins becomes detached, the head is stabilized in a neutral position by one person while another notifies the neurosurgeon. The skin under the halo vest is inspected for excessive perspiration, redness, and skin blistering, especially on the bony prominences. The vest is opened at the sides to allow the torso to be washed. The liner of the vest should not become wet because dampness can cause skin excoriation. The liner should be changed periodically to promote hygiene and good skin care.

A pediatric nurse is caring for a child who has been brought to the clinic with otitis externa. What assessment finding is characteristic of otitis externa? A) Tophi on the pinna and ear lobe B) Dark yellow cerumen in the external auditory canal C) Pain on manipulation of the auricle D) Air bubbles visible in the middle ear

C) Pain on manipulation of the auricle Tophi are deposits of uric acid crystals and are generally painless; they are a common physical assessment finding in patients diagnosed with gout. Cerumen is a normal finding during assessment of the ear canal. Its presence does not necessarily indicate that inflammation is present. Pain when the nurse pulls gently on the auricle in preparation for an otoscopic examination of the ear canal is a characteristic finding in patients with otitis externa. Air bubbles in the middle ear may be visualized with the otoscope; however, these do not indicate a problem involving the ear canal. Aural tenderness or pain is not usually associated with middle ear disorders.

The nurse is conducting a physical assessment of a male patient who has been admitted to the hospital unit. The nursing documentation on the unit specifies an assessment of the patient's direct and consensual pupillary response. How should the nurse assess the patient's consensual pupillary response? A) Ask the patient to follow the movement of pen from several feet away to near the tip of the patient's nose B) Ask the patient to look straight ahead while bringing a penlight in from the periphery of the patient's vision C) Shine a penlight in one of the patient's eyes while observing the response of the opposite eye D) Shine a penlight in the patient's eye while asking him to identify a common object with the other eye

C) Shine a penlight in one of the patient's eyes while observing the response of the opposite eye. The pupillary response to light is determined by shining a bright light obliquely into each pupil. Pupils are assessed for direct reaction, in which the pupil tested with light constricts; and consensual reaction, in which the pupil of the opposite eye also constricts. Asking the patient to follow movement or identify an object are not techniques used to assess consensual pupillary response.

Which finding indicates increasing intracranial pressure (ICP) in the client who has sustained a head injury? A) Increased pulse B) Decreased respirations C) Widened pulse pressure D) Decreased body temperature

C) Widened pulse pressure. Signs of increasing ICP include slowing of the heart rate (bradycardia), increasing systolic blood pressure, and widening pulse pressure (Cushing reflex). As brain compression increases, respirations become rapid, blood pressure may decrease, and the pulse slows further. This is an ominous development, as is a rapid fluctuation of vital signs. Temperature is maintained at less than 38°C (100.4°F). Tachycardia and arterial hypotension may indicate that bleeding is occurring elsewhere in the body.

A client is transferred to the intensive care unit after evacuation of a subdural hematoma. Which nursing intervention reduces the client's risk of increased intracranial pressure (ICP)? A) Encouraging oral fluid intake B) Suctioning the client once each shift C) Elevating the head of the bed 90 degrees D) Administering a stool softener as ordered

D) Administering a stool softener as ordered To prevent the client from straining at stool, which may cause a Valsalva maneuver that increases ICP, the nurse should institute a regular bowel program that includes use of a stool softener. For a client at risk for increased ICP, the nurse should prevent, not encourage, oral fluid intake and should elevate the head of the bed only 30 degrees. Suctioning, indicated for a client with lung congestion, isn't necessary for this client.

Audiometry confirms a client's chronic progressive hearing loss. Further investigation reveals ankylosis of the stapes in the oval window, a condition that prevents sound transmission. This type of hearing loss is called: A) functional hearing loss. B) fluctuating hearing loss. C) sensorineural hearing loss. D) conductive hearing loss.

D) Conductive hearing loss Conductive hearing loss results from interference with the conduction of sound waves (sound transmission) from the tympanic membrane to the inner ear. The stapes must move freely for sound to be transmitted. Bone tissue overgrowth causes the stapes to become fixed or immobile (ankylosed) in the oval window, preventing sound transmission. In a functional hearing loss, no organic lesion is found. Fluctuating hearing loss is a form of sensorineural hearing loss that varies over time. Sensorineural hearing loss affects the inner ear and involves the cochlea and eighth cranial nerve.

A client is receiving mitoxantrone for treatment of secondary progressive multiple sclerosis (MS). This client should be closely monitored for A) mood changes and fluid and electrolyte alterations. B) renal insufficiency. C) hypoxia. D) leukopenia and cardiac toxicity.

D) Leukopenia and cardiac toxicity Mitoxantrone is an antineoplastic agent used primarily to treat leukemia and lymphoma but is also used to treat secondary progressive MS. Clients need to have laboratory tests ordered and the results closely monitored due to the potential for leukopenia and cardiac toxicity. Clients receiving corticosteroids are monitored for side effects related to corticosteroids, such as mood changes and fluid and electrolyte alterations.

Which nursing intervention can prevent a client from experiencing autonomic dysreflexia? A) Administering zolpidem tartrate (Ambien) B) Assessing laboratory test results as ordered C) Placing the client in Trendelenburg's position D) Monitoring the patency of an indwelling urinary catheter

D) Monitoring the patency of an indwelling urinary catheter A full bladder can precipitate autonomic dysreflexia, the nurse should monitor the patency of an indwelling urinary catheter to prevent its occlusion, which could result in a full bladder. Administering zolpidem tartrate, assessing laboratory values, and placing the client in Trendelenburg's position can't prevent autonomic dysreflexia.

A client is brought to the emergency department in a confused state, with slurred speech, characteristics of a headache, and right facial droop. The vital signs reveal a blood pressure of 170/88 mm Hg, pulse of 92 beats/minute, and respirations at 24 breaths/minute. On which bodily system does the nurse focus the nursing assessment? A) Cardiovascular system B) Respiratory system C) Endocrine system D) Neurovascular system

D) Neurovascular system The client is exhibiting signs of an evolving cerebrovascular accident, possibly hemorrhagic in nature, with neurologic complications. Nursing assessment will focus on the neurovascular system assessing level of consciousness, hand grasps, communication deficits, etc. Continual cardiovascular assessment is important but not the main focus of assessment. Respiratory compromise is not noted as a concern. The symptoms exhibited are not from an endocrine dysfunction.

The nurse is doing discharge teaching with a client newly diagnosed with Ménière's disease. Why would the nurse advise a low-sodium diet to this client? A) To minimize the adverse effects of drug therapy B) To reduce the magnitude of the hearing deficit C) To minimize the risk of a tumor that involves the vestibulocochlear nerve D) To reduce the production of fluid in the inner ear

D) To reduce the production of fluid in the ear. A low-sodium diet lessens edema. This measure does not help minimize the adverse effects of drug therapy, reduce the magnitude of the hearing deficit, or minimize the risk of a tumor that involves the vestibulocochlear nerve.

Which term refers to surgical repair of the tympanic membrane? A) Tympanotomy B) Myringotomy C) Ossiculoplasty D) Tympanoplasty

D) Tympanoplasty Tympanoplasty may be necessary to repair a scarred eardrum. A tympanotomy, or myringotomy, are incisions into the tympanic membrane. An ossiculoplasty is a surgical reconstruction of the middle ear bones to restore hearing.

A client undergoes a craniotomy with supratentorial surgery to remove a brain tumor. On the first postoperative day, the nurse notes the absence of a bone flap at the operative site. How should the nurse position the client's head? A) Flat B) Turned onto the operative side C) Elevated no more than 10 degrees D) Elevated 30 degrees

D) elevated 30 degrees. After supratentorial surgery, the nurse should elevate the client's head 30 degrees to promote venous outflow through the jugular veins. The nurse would keep the client's head flat after infratentorial, not supratentorial, surgery. However, after supratentorial surgery to remove a chronic subdural hematoma, the neurosurgeon may order the nurse to keep the client's head flat; typically, the client with such a hematoma is older and has a less expandable brain. A client without a bone flap can't be positioned with the head turned onto the operative side because doing so may injure brain tissue. Elevating the head 10 degrees or less wouldn't promote venous outflow through the jugular veins.

A patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign? A) A significant loss of central vision B) Diminished acuity C) Pain associated with a purulent discharge D)The presence of halos around lights

D) the presence of halos around lights